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An overview of nocturia and the syndrome of nocturnal polyuria in the elderly

Nature Clinical Practice Nephrology volume 4, pages 426–435 (2008)Cite this article

Abstract

Nocturia is common in the elderly population and, aside from being a nuisance, it is associated with morbidity and mortality. Nocturia results from the complex interactions of several factors: changes in the urinary system and renal function with aging, the effects of sleep on renal function, changes in sleeping patterns associated with aging, and the presence of concurrent diseases and medications. Nocturia in the elderly can be caused by many conditions; a common cause is the syndrome of nocturnal polyuria. Although the pathophysiology of nocturnal polyuria remains obscure, some investigators believe that low night-time levels of antidiuretic hormone are involved. Proper management of nocturia requires identification of the specific underlying causes. This Review provides an overview of the mechanisms, evaluation and treatment of nocturia for the practicing nephrologist.

Key Points

  • Nocturia is common in the elderly population, affecting 80–90% of people over 80 years of age, and is associated with increased morbidity and mortality

  • Nocturia is not always symptomatic of a urologic problem

  • The pathophysiology of nocturia is complex, resulting from the interactions between age-related changes in the urinary system, renal function, and sleep architecture

  • Nocturnal polyuria, a common cause of nocturia, is a syndrome in which a disproportionate volume of urine is voided at night; nocturnal polyuria might represent a deficiency of nocturnal antidiuretic hormone secretion

  • Correct treatment of nocturia demands proper evaluation of the patient and management of any underlying medical conditions

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Figure 1: Nocturia in the elderly arises from the complex interaction of several physiological and pathophysiological processes.

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Acknowledgements

The authors acknowledge Gregory Marlowe for his contribution to the manuscript.

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  1. DA Kujubu is Program Director of the Nephrology Fellowship at Kaiser Permanente Los Angeles Medical Center and a Member of the Clinical Faculty at UCLA School of Medicine, Los Angeles, CA, USA.,

    Dean A Kujubu

  2. SR Aboseif is Director of the Neuro Urology and Reconstructive Surgery program at Kaiser Permanente Los Angeles Medical Center and a Member of the Clinical Faculty in the Department of Urology at the University of Southern California, Keck School of Medicine, Los Angeles, CA, USA.,

    Sherif R Aboseif

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Kujubu, D., Aboseif, S. An overview of nocturia and the syndrome of nocturnal polyuria in the elderly. Nat Rev Nephrol 4, 426–435 (2008). https://doi.org/10.1038/ncpneph0856

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